USING PROFESSIONAL PRACTICE MODELS: A PHENOMENOGRAPHIC STUDY OF PROFESSIONAL PRACTICE EXPERTS' CONCEPTIONS

Abstract

<p><strong>Abstract</strong></p> <p>Health care practice environments are central to the safety and quality of patient care. Hospitals often develop and implement a professional practice model (PPM) to improve practice environments. In the United States, magnet hospital designation is a driving force in PPM implementation. In Ontario, Canada, despite the lack of magnet hospital designation, many hospitals have implemented PPMs. There appear to be differences in how PPMs are implemented in Ontario.</p> <p>This phenomenographic study examined professional practice experts’ conceptions of PPM implementation and use in Ontario acute care hospitals. The findings indicate that PPM implementation is a dynamic and emergent phenomenon that occurs in cyclical phases of growth and reduced activity.</p> <p>Seven categories of PPM use are described (a) creating alignment/consistency, (b) supporting evidence-based practice, (c) enabling interprofessional practice, (d) enhancing professional accountability, (e) enabling patient-centred care, (f) creating/ strengthening linkages, and (g) strategic positioning of professional practice. Categories exhibited hierarchical relationships, with more foundational uses providing support for higher level uses.</p> <p>Three structural themes are identified (a) model design/structure, (b) professional practice leadership, and (c) organizational support. These themes work individually and synergistically, within and across the categories to influence use and potential impact of the PPM. Progressively fuller and more complex use of the PPM appears to occur under increasingly intense influence of the structural themes.</p> <p>The analysis provides unique information about relationships within and among categories of PPM use. This provides insight regarding how organizations might maximize return on investment with PPM implementation. Seven recommendations are identified.</p>